MONDAY, Nov. 2 (HealthDay News) -- A brief course of hormone-blocking therapy can provide small benefits to a specific group of men who get radiation therapy for prostate cancer, a long-running study shows.

Ten-year survival was 62 percent in men with cancers graded as intermediate risk who got treatment that blocked their male hormone activity in addition to radiation therapy, compared to 57 percent of those who got radiation therapy alone, said Dr. Christopher U. Jones, a radiation oncologist at Radiological Associates of Sacramento, a member of the group who reported the results Monday at the American Society for Radiation Oncology annual meeting, in Chicago.

When biopsies were taken from men in the group, no traces of cancer were found in 78 percent of those having combined hormone-radiation therapy, compared to 60 percent of those who got radiation therapy alone.

The benefit is statistically significant but not huge, because "we weren't expecting large differences" in such cases, Jones said. And while study results already are incorporated in medical practice, it is not the final word on the issue, since the field is still evolving, he said.

"The standard of care in radiation therapy has changed since the study began in 1994," Jones said. "We can now localize treatment more so we give higher doses of radiation, 50 percent higher."

Even the definition of "intermediate risk" has changed over the years, he said. It is based on such factors as levels of prostate-specific antigen, a hormone produced by the gland, and Gleason score, a measure of the prostate's orderly structure.

"Since the study opened, we have more data and are better able to determine who is truly at low risk," Jones said. "Of the 2,000 we enrolled, we now know that 685 were truly low-risk, 1,068 were at intermediate risk and 226 were high-risk."

His summary of the results: "For the low-risk group, there is very little benefit in adding hormonal therapy. The most benefit is for those at intermediate risk, with high-risk patients in the middle."

In other words, "what we can show in this study is that patients can be spared hormonal therapy if they fit the modern definition of low-risk," Jones said.

That can be a big help, since side effects of hormone-blocking therapy include impotence and hot flashes, he said.

One reason why the study was undertaken was a growing use of hormonal therapy for men getting radiation treatment for prostate cancer, explained Dr. Anthony Zietman, a professor of radiation oncology at Harvard Medical School, incoming president of the radiation oncology society.

"There were some worries about the long-term consequences of hormone-deprivation therapy," Zietman said. "This study tells us that the majority of guys diagnosed with prostate cancer don't need hormone therapy at all."

Decision-making in such cases starts with a choice between surgery or radiation therapy. Physicians tend to prefer surgery for younger patients, but that decision can also depend on the choice of the patient, Zietman said. And there is some flexibility in the actual treatment to be given.

If radiation is the choice, treatment can then consist of a little bit of hormone therapy, for four months, or an increased radiation dose, he said.

"We know now that higher doses of radiation are better than lower doses," Jones said. "If higher doses of radiation are used, do you also need hormone therapy? A trial is just opening to ask that question."

Two other reports presented at the meeting revealed favorable results about proton therapy, in which prostate cancer is attacked by a beam of protons rather than X-rays. Physicians at the University of Florida in Jacksonville reported that proton therapy did not appear to have harmful effects to the urinary system, which had been feared. And a study at Loma Linda University in California found that a booster round of proton therapy reduced recurrence of prostate cancer in men who first had X-ray treatment.

More information

Learn about prostate cancer diagnosis and treatment from the U.S. National Cancer Institute.

THURSDAY, Aug. 6 (HealthDay News) -- New research shows that men diagnosed with the chest pain called angina did much worse than women, and neither artery-opening angioplasty nor coronary-bypass surgery reduced long-term mortality for either gender.

The study of 1,785 people newly diagnosed with angina at 40 primary-care practices in Scotland confirmed a previously reported difference between men and women that is something of a medical mystery, said Dr. Brian Buckley, a research fellow in the National University of Ireland department of general practice, and lead author of an Aug. 7 online report in BMJ.

The study, done in collaboration with physicians at the University of Aberdeen in Scotland, found that in the five years following the diagnosis, men were twice as likely to have a heart attack and three times more likely to die of a heart-related condition.

"A lot of practicing doctors would have a hunch that would be the case," Buckley said. "Reports of that difference actually go back about 10 years. We pretty well demonstrate that it is a reality."

Asked if he knew the reason for the difference, Buckley said, "I wish I did. We can't tell people why it is so. We need further research to get into the details of why men are doing worse than women."

Lifestyle factors clearly made a difference in outcome. Smoking doubled the risk of a heart attack and death from all causes, as did obesity, the study authors noted.

Men were more likely than women to have angioplasty or bypass surgery, but the study found no difference in survival for those who had either intervention.

"Bypass surgery does work for many people, there is no doubt about that," Buckley said. "Maybe people who have it should be chosen more carefully than they are. Angina is an early stage of heart disease. At that stage, maybe it doesn't have the effect that might help at a later stage."

The study does indicate the need for emphasizing "lifestyle risk factors and optimal medical [drug] treatment" after a diagnosis of angina, Buckley said.

"For many people, the important thing when they are diagnosed with angina is to look at their lifestyle and do what can be done about it," he said. "Medications to reduce blood pressure and cholesterol are good. If you could do that without drugs, so much the better. There are a lot of risk factors that can be managed, and when you do that you are avoiding heart attacks and deaths."

The findings should be interpreted cautiously, said Dr. Gregg C. Fonarow, a professor of medicine at the University of California, Los Angeles, and director of the Ahmanson-UCLA Cardiomyopathy Center. One reason is that a diagnosis of angina does not pinpoint the cause of the chest pain, he said.

"Angina is a lot of challenges," Fonarow said. "It can mean a lot of different things to a lot of different people."

And the study was observational, meaning that it dealt with all the people seen at the medical practices rather than being a controlled trial in which participants are carefully matched, he said. "Treatment was decided upon not by randomization but just by defining the condition," Fonarow said. "You need a randomized clinical trial to get definitive results."

But the difference in outcome between men and women appears real, although the reasons for it remain unknown, Fonarow said. "That simply hasn't been established," he said.

More information

Angina and its treatment are described by the American Heart Association  .